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https://www.readbyqxmd.com/read/27925837/a-comprehensive-multimorbidity-index-for-predicting-mortality-in-intensive-care-unit-patients
#1
Hua Min, Sanja Avramovic, Janusz Wojtusiak, Rahul Khosla, Ross D Fletcher, Farrokh Alemi, Raya Elfadel Kheirbek
BACKGROUND: Accurate prediction of mortality for patients admitted to the intensive care units (ICUs) is an important component of medical care. However, little is known about the role of multimorbidity in predicting end of life for high-risk and vulnerable patients. OBJECTIVE: The aim of the study was to derive and validate a multimorbidity risk model in an attempt to predict all-cause mortality at 6 and 12 months posthospital discharge. METHODS: This is a retrospective, observational, clinical cohort study...
December 7, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27925393/intensive-care-unit-icu-readmission-after-major-lung-resection-prevalence-patterns-and-mortality
#2
Jae Jun Jung, Jong Ho Cho, Tae Hee Hong, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Jae Ill Zo
BACKGROUND: The aim of this study was to identify risk factors associated with mortality in patients re-admitted to an intensive care unit (ICU) after initial recovery from major lung resection. METHODS: We retrospectively reviewed the case records of all patients who underwent major lung resection between February 2011 and May 2013. A total of 1916 patients underwent major resection surgery for various lung diseases, 63 (3.3%) of which required ICU admission after initial recovery...
December 7, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/27924871/prognostic-implications-of-aspiration-pneumonia-in-patients-with-community-acquired-pneumonia-a-systematic-review-with-meta-analysis
#3
Kosaku Komiya, Bruce K Rubin, Jun-Ichi Kadota, Hiroshi Mukae, Tomohiro Akaba, Hiroshi Moro, Nobumasa Aoki, Hiroki Tsukada, Shingo Noguchi, Nobuaki Shime, Osamu Takahashi, Shigeru Kohno
: Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP. This review was conducted using the MOOSE guidelines: Patients: patients defined CAP. EXPOSURE: aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to be at high risk for oral aspiration...
December 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27924831/incidence-risk-factors-and-impact-on-outcomes-of-secondary-infection-in-patients-with-septic-shock-an-8-year-retrospective-study
#4
Guang-Ju Zhao, Dong Li, Qian Zhao, Jia-Xing Song, Xiao-Rong Chen, Guang-Liang Hong, Meng-Fang Li, Bing Wu, Zhong-Qiu Lu
Secondary infection in septic patients has received widespread attention, although clinical data are still lacking. The present study was performed on 476 patients with septic shock. Time trends for mortality were analyzed using Spearman's rank correlation test. Risk factors for secondary infection were investigated by binary logistic regression. The extended Cox model with time-varying covariates and hazard ratios (HR) was performed to determine the impact of secondary infection on mortality. Differences in hospital length of stay (LOS) between patients with and without secondary infection were calculated using a multistate model...
December 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27924681/factors-associated-with-30-day-mortality-in-elderly-inpatients-with-community-acquired-pneumonia-during-two-influenza-seasons
#5
Núria Torner, Conchita Izquierdo, Núria Soldevila, Diana Toledo, Judith Chamorro, Elena Espejo, Amelia Fernández-Sierra, Angela Domínguez
Community-acquired pneumonia (CAP) refers to pneumonia unrelated to hospitals or extended-care facilities. The aim of this study was to determine factors associated with 30-day mortality in patients with CAP aged ≥65 years admitted to 20 hospitals in seven Spanish regions during the 2013-14 and 2014-15 influenza seasons. Logistic regression was used to identify factors associated with 30-day mortality. The adjusted model included variables selected by backward elimination with a cut off of < 0.02. A total of 1928 CAP cases were recorded; 60...
December 7, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27923757/the-potentially-fatal-ogilvie-s-syndrome-in-lateral-transpsoas-access-surgery-a-multi-institutional-experience-with-2930-patients
#6
Jacob Januszewski, Sean K Keem, William Smith, Joshua M Beckman, Adam S Kanter, Rod J Oskuian, William Taylor, Juan S Uribe
BACKGROUND: Ogilvie's syndrome (OS) is a relatively uncommon pathology characterized by significant colonic dilation in the absence of mechanical obstruction. If unrecognized and untreated, cecal perforation resulting in mortality rate of 25-71% may occur. It is a potentially underdiagnosed condition in the lateral transpsoas appraoch population due to its uncommon nature and imitation of other well-known pathologies. METHODS: A total of 2930 patients from 6 separate institutions were retrospectively reviewed since 2007 and screened for OS...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27923397/pharmacological-interventions-for-delirium-in-intensive-care-patients-a-protocol-for-an-overview-of-reviews
#7
Marija Barbateskovic, Laura Krone Larsen, Marie Oxenbøll-Collet, Janus Christian Jakobsen, Anders Perner, Jørn Wetterslev
BACKGROUND: The prevalence of delirium in intensive care unit (ICU) patients is high. Delirium has been associated with morbidity and mortality including more ventilator days, longer ICU stay, increased long-term mortality and cognitive impairment. Thus, the burden of delirium for patients, relatives and societies is considerable. Today, reviews of randomised clinical trials are produced in large scales sometimes making it difficult to get an overview of the available evidence. A preliminary search identified several reviews investigating the effects of pharmacological interventions for the management and prevention of delirium in ICU patients...
December 7, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27922906/patient-outcomes-after-early-versus-late-tracheostomy-in-the-puerto-rico-trauma-hospital
#8
Ana M Romero Vázquez, Omar García Rodríguez, Ediel Ramos Meléndez, Pablo Rodríguez Ortiz
OBJECTIVE: This study aimed to evaluate the impact of early tracheostomy (ET, ≤7 days) versus that of late tracheostomy (LT, >7 days) on outcomes such as hospital length of stay (LOS), intensive care unit (ICU) days, mechanical ventilation (MV) days, and mortality ratio. METHODS: A historical cohort study was undertaken using charts of patients admitted to the Puerto Rico Trauma Hospital who required MV and underwent tracheostomies, from 2000 to 2013. A logistic regression was performed to evaluate the association between timing of tracheostomy and complications and mortality...
December 5, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27922878/higher-fluid-balance-increases-the-risk-of-death-from-sepsis-results-from-a-large-international-audit
#9
Yasser Sakr, Paolo Nahuel Rubatto Birri, Katarzyna Kotfis, Rahul Nanchal, Bhagyesh Shah, Stefan Kluge, Mary E Schroeder, John C Marshall, Jean-Louis Vincent
OBJECTIVES: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. DESIGN: Observational cohort study. SETTING: Seven hundred and thirty ICUs in 84 countries. PATIENTS: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance...
December 5, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27922845/continued-under-recognition-of-acute-respiratory-distress-syndrome-after-the-berlin-definition-what-is-the-solution
#10
John G Laffey, Tài Pham, Giacomo Bellani
PURPOSE OF REVIEW: Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. RECENT FINDINGS: ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common...
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#11
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#12
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27919645/empirical-mono-versus-combination-antibiotic-therapy-in-adult-intensive-care-patients-with-severe-sepsis-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#13
REVIEW
Fredrik Sjövall, Anders Perner, Morten Hylander Møller
OBJECTIVES: To assess benefits and harms of empirical mono- vs. combination antibiotic therapy in adult patients with severe sepsis in the intensive care unit (ICU). METHODS: We performed a systematic review according to the Cochrane Collaboration methodology, including meta-analysis, risk of bias assessment and trial sequential analysis (TSA). We included randomised clinical trials (RCT) assessing empirical mono-antibiotic therapy versus a combination of two or more antibiotics in adult ICU patients with severe sepsis...
December 2, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#14
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27916049/-a-retrospective-clinical-study-of-sixty-three-cases-with-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#15
R Y Ding, J N Qiu, B Y Liu, X X Li, Y N Sun, Y J Liang, D M Zhao, R Zhu, Z D Zhang, X C Ma
Objective: To study the clinical characteristics and prognosis of patients with persistent inflammation immunosuppression and catabolism syndrome (PICS) in ICU. Methods: A total of 126 patients admitted to ICU (ICU stay of more than 10 days, age≥18 years) between January 2014 to December 2014 were retrospectively studied.Data were collected from electronic medical records including demographics, underlying disease, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, Sequential Organ Failure Assessment (SOFA) score, laboratory parameters, ICU acquired infections and clinical outcome...
December 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#16
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#17
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
November 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27915096/universal-contact-precautions-do-not-change-the-prevalence-of-antibiotic-resistant-organisms-in-a-tertiary-burn-unit
#18
Adelyn L Ho, Reid Chambers, Claudia Malic, Anthony Papp
OBJECTIVE: The prevalence of antibiotic-resistant organisms (ARO) in burn units is increasing worldwide and contributes significantly to morbidity and mortality. Study aims are to describe the burden of AROs in burn patients admitted to a tertiary burn unit, to evaluate the impact of contact precautions implemented after an outbreak of antibiotic-resistant Acinetobacter baumannii, and to identify possible predictors of ARO acquisition. METHODS: Data of burn inpatients between 2006 and 2010 were retrospectively reviewed...
November 30, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27914908/association-between-ventilatory-settings-and-development-of-acute-respiratory-distress-syndrome-in-mechanically-ventilated-patients-due-to-brain-injury
#19
Eva Tejerina, Paolo Pelosi, Alfonso Muriel, Oscar Peñuelas, Yuda Sutherasan, Fernando Frutos-Vivar, Nicolás Nin, Andrew R Davies, Fernando Rios, Damian A Violi, Konstantinos Raymondos, Javier Hurtado, Marco González, Bin Du, Pravin Amin, Salvatore M Maggiore, Arnaud W Thille, Marco Antonio Soares, Manuel Jibaja, Asisclo J Villagomez, Michael A Kuiper, Younsuck Koh, Rui P Moreno, Amine Ali Zeggwagh, Dimitrios Matamis, Antonio Anzueto, Niall D Ferguson, Andrés Esteban
PURPOSE: In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. MATERIALS AND METHODS: We performed a secondary analysis of a prospective, observational study on mechanical ventilation...
November 18, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27914671/current-practice-in-continuous-renal-replacement-therapy-an-epidemiological-multicenter-study
#20
T M Tomasa Irriguible, J Sabater Riera, E Poch López de Briñas, J Fort Ros, M J Lloret Cora, J Roca Antònio, A Navas Pérez, P Ortiz Ballujera, L Servià Goixart, F J González de Molina Ortiz, C Rovira Anglès, A Roglan Piqueras, M Rodríguez López
OBJECTIVE: The aim of the study is to ascertain the most relevant aspects of the current management of renal replacement therapy (RRT) in critically ill patients, and to analyze renal function recovery and mortality in patients undergoing RRT. METHODS: A non-interventional three-month observational study was made in 2012, with a follow-up period of 90 days, in 21 centers in Catalonia (Spain). Demographic information, severity scores and clinical data were obtained, as well as RRT parameters...
November 30, 2016: Medicina Intensiva
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